1
|
Ride J, Cameron L, Jones R, Hall T, Cameron F, White M. Participation and psychosocial supports in the school setting for children with type 1 diabetes: A discrete choice experiment of carer priority. Diabetes Res Clin Pract 2024; 213:111753. [PMID: 38906333 DOI: 10.1016/j.diabres.2024.111753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 05/14/2024] [Accepted: 06/17/2024] [Indexed: 06/23/2024]
Abstract
School-based diabetes care is an important consideration for clinicians and families alike. This Discrete-Choice Experiment describes parental preference for enhanced psychosocial and activity-focused supports over academic supports for children with Type 1 diabetes in Australian primary and secondary schools.
Collapse
Affiliation(s)
- Jemimah Ride
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Lachlan Cameron
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Renee Jones
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia; Health Services Research Unit, The Royal Children's Hospital, Parkville, Melbourne, Australia
| | - Teresa Hall
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia; Health Services Research Unit, The Royal Children's Hospital, Parkville, Melbourne, Australia
| | - Fergus Cameron
- Department of Endocrinology & Diabetes, The Royal Children's Hospital, Parkville, Melbourne, Australia; Diabetes Research, Murdoch Children's Research Institute, Parkville, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Parkville, Melbourne, Australia
| | - Mary White
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia; Health Services Research Unit, The Royal Children's Hospital, Parkville, Melbourne, Australia; Department of Endocrinology & Diabetes, The Royal Children's Hospital, Parkville, Melbourne, Australia; Diabetes Research, Murdoch Children's Research Institute, Parkville, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Parkville, Melbourne, Australia.
| |
Collapse
|
2
|
Thorsted AB, Thygesen LC, Hoffmann SH, Rosenkilde S, Lehn SF, Lundby-Christensen L, Horsbøl TA. Educational outcomes and the role of comorbidity among adolescents with type 1-diabetes in Denmark. Diabet Med 2024; 41:e15270. [PMID: 38173089 DOI: 10.1111/dme.15270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 11/01/2023] [Accepted: 12/06/2023] [Indexed: 01/05/2024]
Abstract
AIMS To examine educational outcomes among adolescents with type 1 diabetes and determine the role of comorbidity. METHODS We conducted a nationwide register-based cohort study including 3370 individuals born between 1991 and 2003 and diagnosed with type 1 diabetes before the age of 16. They were all matched with up to four individuals without type 1 diabetes on age, gender, parents' educational level and immigration status. Information on comorbidity was based on hospital diagnoses. The individuals were followed in registers to determine whether they finished compulsory school (9th grade, usually at the age of 15-16 years), and were enrolled in secondary education by age 18 years. RESULTS Individuals with type 1 diabetes were more likely not to complete compulsory school (OR 1.44, 95% CI 1.26-1.64), and not being enrolled in an upper secondary education by age 18 (OR 1.50, 95% CI 1.31-1.73) compared to their peers. A total of 1869 (56%) individuals with type 1 diabetes were registered with at least one somatic (n = 1709) or psychiatric comorbidity (n = 389). Those with type 1 diabetes and psychiatric comorbidity were more likely not to complete compulsory school (OR 2.47, 95% CI 1.54-3.96), and not being enrolled in an upper secondary education by age 18 (OR 3.66, 95% CI 2.27-5.91) compared to those with type 1 diabetes only. Further, there was a tendency towards an association between having somatic comorbidity and adverse educational outcomes (OR 1.25, 95% CI 0.97-1.63; OR 1.26, 95% CI 0.95-1.66) among adolescents with type 1 diabetes. The associations differed markedly between diagnostic comorbidity groups. CONCLUSION Type 1 diabetes affects educational attainment and participation among adolescents. Psychiatric comorbidity contributes to adverse educational outcomes in this group, and there is a tendency that somatic comorbidity also plays a role.
Collapse
Affiliation(s)
- Anne Bonde Thorsted
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Lau Caspar Thygesen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Sofie Have Hoffmann
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Siri Rosenkilde
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Sara Fokdal Lehn
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
- Steno Diabetes Center Sjaelland, Holbæk, Denmark
| | - Louise Lundby-Christensen
- Department of Pediatrics and Adolescents Medicine, Amager and Hvidovre University Hospital, Hvidovre, Denmark
| | | |
Collapse
|
3
|
Bowden N, Dixon R, Anderson V, de Bock M, Boucsein A, Kewene-Edwards M, Gibb S, Kokaua J, Palmer O, Paul R, Taylor B, Vu H, Wheeler BJ. Associations between type 1 diabetes and educational outcomes: an Aotearoa/New Zealand nationwide birth cohort study using the Integrated Data Infrastructure. Diabetologia 2024; 67:62-73. [PMID: 37870651 PMCID: PMC10709242 DOI: 10.1007/s00125-023-06026-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 08/31/2023] [Indexed: 10/24/2023]
Abstract
AIMS/HYPOTHESIS Type 1 diabetes is one of the most common chronic diseases of childhood. It is hypothesised that the metabolic and psychosocial consequences of type 1 diabetes may affect educational outcomes; however, existing literature presents conflicting results. This study aimed to assess whether educational outcomes differ for young people with and without type 1 diabetes in Aotearoa/New Zealand (NZ). METHODS This was a nationwide 9 year birth cohort study of all people born in NZ from 1993 to 2001 using linked administrative data held within the Integrated Data Infrastructure, a national research database containing linked health and non-health data. Educational outcomes of high school attainment, high school attendance and university enrolment were measured from age 13 years until 20 years. Generalised linear regression models with log link and Gaussian distributions were used to compare educational outcomes between those with and those without type 1 diabetes, adjusting for sociodemographic and maternal characteristics. RESULTS Of the 442,320 children in the birth cohort, type 1 diabetes was identified in 2058 (0.47%) (mean [SD] age of type 1 diabetes diagnosis 7.7 [3.4] years). Educational outcomes were significantly lower for children with type 1 diabetes than for those without type 1 diabetes, including for any high school qualification (RR 0.97 [95% CI 0.95, 0.99]), university entrance-level high school attainment (RR 0.88 [95% CI 0.84, 0.92]), regular high school attendance (RR 0.91 [95% CI 0.85, 0.97]) and university enrolment (RR 0.93 [95% CI 0.88, 0.98]), even after adjusting for sociodemographic and maternal factors. In addition, educational outcomes were substantially lower for those with post type 1 diabetes diagnosis hospitalisations for diabetic ketoacidosis and hypoglycaemia. CONCLUSIONS/INTERPRETATION In this whole NZ birth cohort study, type 1 diabetes was associated with lower educational outcomes spanning secondary school and into university enrolment. Ongoing efforts to support students with type 1 diabetes are needed, particularly for those with a greater risk profile.
Collapse
Affiliation(s)
- Nicholas Bowden
- Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
- A Better Start National Science Challenge, Auckland, New Zealand
| | - Rachael Dixon
- Faculty of Health, University of Canterbury, Christchurch, New Zealand
| | | | - Martin de Bock
- Department of Paediatrics, Te Whatu Ora/Health NZ, Christchurch, New Zealand
- Department of Paediatrics, University of Otago, Christchurch, New Zealand
| | - Alisa Boucsein
- Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | | | - Sheree Gibb
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Jesse Kokaua
- Centre for Pacific Health, Va'a O Tautai, Health Sciences Division, University of Otago, Dunedin, New Zealand
| | - Octavia Palmer
- Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Ryan Paul
- Waikato Regional Diabetes Service, Hamilton, New Zealand
- Te Hutaki Waiora School of Health, University of Waikato, Hamilton, New Zealand
| | - Barry Taylor
- Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
- A Better Start National Science Challenge, Auckland, New Zealand
| | - Hien Vu
- Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Benjamin J Wheeler
- Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
- Paediatric Endocrinology, Te Whatu Ora/Health NZ - Southern, Dunedin, New Zealand.
| |
Collapse
|